Occupational exposures, smoking and airway inflammation in refractory asthma

Jodie L. Simpson, Maya Guest, May Boggess, Peter G. Gibson

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background: The influence of occupation and ex/passive smoking on inflammatory phenotype is not well understood. The aim of this study was to examine the relationship between occupation, past smoking and current passive smoking and airway inflammation in a population of adults with refractory asthma. Methods: Sixty-six participants with refractory asthma were characterised. Occupational exposure to asthma causing or worsening agents were identified with an asthma-specific job exposure matrix. Exposure to passive cigarette smoke was determined by questionnaire and exhaled carbon monoxide assessment. The carbon content of macrophages was assessed in a sub-group of participants. Results: Nineteen participants had smoked previously with low smoking pack years (median 1.7 years). Ex-smokers more commonly lived with a current smoker (26% vs. 9%, p = 0.11) and were more likely to allow smoking inside their home (26% vs. 4%, p = 0.02) compared to never smokers. Twenty participants had occupations with an identified exposure risk to an asthmagen; thirteen had exposures to irritants such as motor vehicle exhaust and environmental tobacco smoke. Sputum neutrophils were elevated in participants with asthma who had occupational exposures, particularly those who were diagnosed with asthma at a more than 30 years of age. Conclusions: Sputum neutrophils are elevated in refractory asthma with exposure to occupational asthmagens. In addition to older age, exposure to both environmental and occupational particulate matter may contribute to the presence of neutrophilic asthma. This may help explain asthma heterogeneity and geographical variations in airway inflammatory phenotypes in asthma.

Original languageEnglish (US)
Article number207
JournalBMC Pulmonary Medicine
Volume14
Issue number1
DOIs
StatePublished - Dec 19 2014

Keywords

  • Neutrophils
  • Occupational exposure
  • Refractory asthma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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